Valerie (Val) Humphreys

@TTeulu @mancunianmedic That was my point - cakes don’t last long enough to go stale around here!

@valhumphreys51 @mancunianmedic It’s a cake. People keep cakes? Not in our house They’re gone.

The mystery of the Victoria Sponge that never rose has been solved The scales was set on a unit that was not grams So whilst the proportions were right (eggs excepted) the quantities were tiny

@TTeulu @mancunianmedic It goes stale quickly

@valhumphreys51 @mancunianmedic Keep?

@Art_Li @medicalmodelbri @swap2013 @Cray_tweets1 Assuming the same categories apply to those who can request a transcript, I guess that answers the Q. Thanks @Art_Li

@valhumphreys51 @medicalmodelbri @swap2013 @Cray_tweets1 judiciary.uk/guidance-and-r…

We need to know what were the reasons behind the coroner’s decision.

@medicalmodelbri @swap2013 As far as I know anyone can get a transcript if they pay for it - but others may know differently @Cray_tweets1 @Art_Li do you know if there are any restrictions?

@swap2013 @valhumphreys51 who would be considered an interested person ? I suppose they won’t just release the inquest transcript to anyone ? inquestrepresentationservice.com/obtaining-an-i…

@parthaskar @iDrSunny @NHSEngland @NICEComms I fear the majority are just not open to new ideas. I don’t know if that’s peculiar to gynae (prob not) but there seems to be a reactionary arrogance in the specialty which isn’t apparent elsewhere. Change is desperately needed and there is little evidence of it being actioned

@valhumphreys51 @iDrSunny @NHSEngland @NICEComms I did my bit in pregnancy related issues (not quite the same appreciably)- as regards turning my thoughts...I could...yet it needs national teams to be also intersted in using my expertise or whatever it is I bring to the table

Whisper it very softly But we may not be too far from nearly 4 in 5 children with #T1Diabetes being on #ClosedLoops 4 in 5 on the best thing science can provide at the moment beyond a cure 2 years since @NHSEngland started their implementation of @NICEComms TA 943 Ka-Boom 😎 A shift of paradigm across a generation A promise made…#gbdoc @danfarrow9 @DrDita @nerdabetic @hilarynathan01 @Jazzsethi95 @kamleshkhunti @ShivaniM_KC

@mancunianmedic Beautiful

@PhilipSteart @Megsenmumdr @ambsavage92 @drokane @ShiYunZhao Do you have a link?

@Megsenmumdr @ambsavage92 @drokane @valhumphreys51 @ShiYunZhao It's interesting that the new DES 26/27 has removed all the references to what PAs should be doing. The expectation that they see undifferentiated undiagnosed patients etc. gone

UPDATE. The inquest has concluded and the coroner has given her verdict. It seems that no blame is attached to anyone.

@Montyburnout123 @Megsenmumdr @ShiYunZhao @drokane Exactly

@Megsenmumdr @valhumphreys51 @ShiYunZhao @drokane If the GPs giving evidence don’t highlight deficiencies, and in doing so imply there was no deviation from accepted standards of care, and there is no other evidence presented suggesting negligence, I would assume the coroner is limited in their options.

@PaulaMc007 @medicalmodelbri @Megsenmumdr @drokane @ShiYunZhao Exactly which is why I think there’s a vanishingly small chance it would happen

@valhumphreys51 @medicalmodelbri @Megsenmumdr @drokane @ShiYunZhao #Oliverscampaign Many families are grieving and in shock, it literally costs tens of thousands to challenge the coroners decision and with a tiny time frame to do so

@DrJoFranklin @Jean_Jeannie1 @drokane @Megsenmumdr @ShiYunZhao I assume bc she was convinced that nothing would have affected the outcome

@valhumphreys51 @Jean_Jeannie1 @drokane @Megsenmumdr @ShiYunZhao Appreciate not Coroners remit to determine how medical services should be staffed, tho findings & PFD often make reference to this, but they can certainly opine on staffing, systems & processes related to any one inquest that might impact future care nationwide. Why not done so?

@PhilipSteart @Jean_Jeannie1 @DrJoFranklin @drokane @Megsenmumdr @ShiYunZhao Yes, I think you’re abs right there

@Jean_Jeannie1 @DrJoFranklin @valhumphreys51 @drokane @Megsenmumdr @ShiYunZhao Just as a general thing I think there is still a lack of understanding by coroner as to what PAs are and the fact that they aren’t medically trained whether they are at fault or not

@DrJoFranklin @Jean_Jeannie1 @drokane @Megsenmumdr @ShiYunZhao Maybe but the coroner seems to have thought that further/different medical care would not have affected the outcome. It’s not her job to apportion blame simply to make that determination.

@valhumphreys51 @Jean_Jeannie1 @drokane @Megsenmumdr @ShiYunZhao Only at level of this one practice, not by all other agencies I mentioned. So all other practices who use PAs & PA apprentices in same way will carry on regardless. Seems, perhaps unduly, influenced by inconclusive PM findings. Opportunities to provide medical care were missed.

@medicalmodelbri @Jean_Jeannie1 @PaulaMc007 @Megsenmumdr @drokane @ShiYunZhao Possibly, but none of us was actually in court. We don’t know what questions Ms Gingell asked or what assurances she was given. Personally I’m not prepared to assume she didn’t do a fair job without evidence of it

@Jean_Jeannie1 @valhumphreys51 @PaulaMc007 @Megsenmumdr @drokane @ShiYunZhao Joanne Kearsley would’ve come to a different conclusion . She already warned about this

@Jean_Jeannie1 @medicalmodelbri @PaulaMc007 @Megsenmumdr @drokane @ShiYunZhao They’re not. Even with my limited experience of inquests, I’ve seen some excellent coroners, some pretty useless and most doing a good job. They have limited powers to effect any meaningful change

@medicalmodelbri @valhumphreys51 @PaulaMc007 @Megsenmumdr @drokane @ShiYunZhao Maybe not all coroners are the same. I'm.worried those practices that greedily use ARRS alongside light touch supervision will see this verdict as permission to carry on. No blame attributed anywhere...much like maternity scandal.

@medicalmodelbri @PaulaMc007 @Megsenmumdr @drokane @ShiYunZhao This has been the case, as you know, for many years. One coroner isn’t going to change that and legal action in itself can’t either. We all know what the issues are and the kinds of actions needed and who can take them - govt, the NHS, the GMC, RCs, senior doctors etc

@valhumphreys51 @PaulaMc007 @Megsenmumdr @drokane @ShiYunZhao Then the likelyhood of more cases coming to light is high . PAs can see complex patients unsupervised and nobody will be held responsible when a patient dies

@Jean_Jeannie1 @DrJoFranklin @drokane @Megsenmumdr @ShiYunZhao A PFD Report is issued only if the coroner identifies significant issues which need to be acted on. She appears to have been satisfied that any concerns raised have already been actioned

@DrJoFranklin @valhumphreys51 @drokane @Megsenmumdr @ShiYunZhao I can't understand why there was no PFD either. The Leng Review & Streeting's own words 'they're not Drs and must not be used as such' - made clear these points. This was a tragedy on so many levels. Could it be a green light for PAs to continue seeing complex patients?

@medicalmodelbri @PaulaMc007 @Megsenmumdr @drokane @ShiYunZhao If they decide not to pursue legal action and they don’t challenge the coroners decision - I think neither is likely tbh - then that’s the end of the matter legally speaking. I imagine they want to start rebuilding their lives and caring for the baby now

@valhumphreys51 @PaulaMc007 @Megsenmumdr @drokane @ShiYunZhao What if the family can’t/or won’t take legal action ? They still need to be answered. The practice changed how they deployed PAs but that is just 1 practice . What about the rest of practices in the U.K. allowing PAs to work in the same way seeing pregnant /post partum pts

@medicalmodelbri @PaulaMc007 @Megsenmumdr @drokane @ShiYunZhao Those sorts of Qs - which may have been raised by the coroner, we don’t know - would likely be answered if legal action were to be brought

@PaulaMc007 @Megsenmumdr @valhumphreys51 @drokane @ShiYunZhao Too many questions 1) complex pt with LD dismissed 3 times as having ‘ anxiety ‘ by non- medical PAs and apprentices who didnt escalate to a GP 2) Who triaged Joanne to see a PA and who was the GP supervisor on each occasion? 3) Why wasn’t the practice following BMA guidance?